Facial expression and the affective component of cynical hostility in male coronary heart disease patients.

This study describes the affective component of hostility as measured by the Cook-Medley Hostility Scale (Ho W. Cook & D. Medley, 1954) by examining the relationship between facial expressions of emotion and Ho scores in 116 male coronary heart disease patients. Patients underwent the videotaped Type A Structured Interview, from which facial expressions were later coded using the Facial Action Coding System. They also completed the Cook-Medley Ho scale. Facial expression of the emotion of contempt was significantly related to Ho scores; anger expression was not. Also, there was a significant interaction between hostility and defensiveness, wherein low-defensive, highly hostile people showed substantially more contempt expression than others. The implications of these findings for the construct validity of Ho and for identifying clinically important subtypes of hostility are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-esteem, manifest hostility, and expression of hostility.

In a previous study (see 34: 7173), it was shown that Ss with low self-esteem, as measured by the Self-Esteem Scale, and high manifest hostility, as measured by Siegel's (1956) Manifest Hostility scale (MH scale), were found to have a high hostility response tendency. In the present study, arousal of hostility was stimulated by criticizing college Ss performing tests, measured via TAT cards, and related to the measure of self-esteem. Ss with a high degree of hostility arousal showed high MH scale scores but not low scores on the Self-Esteem Scale. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Gender differences in the relation between interview-derived hostility scores and resting blood pressure

We examined the correlations between Structured Interview (SI)-derived hostility scores and resting blood pressure (BP) to see if they would be the same or different for healthy men and women. Standard risk factor information and resting BP measures were obtained from 193 undergraduates (109 men, 84 women), who underwent the SI. Subjects were rated for Potential for Hostility, Hostile Style, Intensity and Content, and completed Antagonism and Neuroticism scales. As expected, SI hostility scores were related to higher resting SBP in men, however; in women, they were related to lower resting SBP and Neuroticism. Regression analyses controlling for standard CHD risk factors indicated that SI-derived hostility predicted resting SBP and hypertensive status in both men and women, though in opposite directions. Thus, SI-derived hostility may assess a different construct in women than in men.     

Hostility, relationship quality, and health among African American couples.

Objective: This study investigated the association between hostility and health and whether it is moderated by the quality of an individual's primary romantic relationship. Method: Longitudinal data were provided by 184 African Americans, including 166 women. Participants averaged 38 years old and were married or in long-term marriagelike relationships. Hostility and relationship quality were measured at the first assessment. Hostility was based on participants' responses to items tapping cynical attitudes about relationships. Relationship quality was based on trained observer ratings of videotaped couple interactions on behavioral scales reflecting warmth, support, and communication skills. At 2 assessments approximately 5 and 7 years later, participants provided health data. Health index scores were formed from responses to five scales of the SF-12 (Ware, Kosinski, & Keller, 1998) as well as to responses to questions about the number of chronic health conditions and the number of prescribed medications. Results: Stepwise regression analyses controlling for demographic variables and the earlier health score tested the main and interactive effects of hostility and relationship quality on longitudinal changes in health. Whereas no main effects were supported, the interaction of hostility and relationship quality was significant (p     

Hostility, social support, and perceptions of work.

The aim of this study was to determine whether hostility and perceived availability of social support are related to perceptions of the work environment. The W. W. Cook and D. M. Medley (1954) Hostility (Ho) scale; the Interpersonal Support Evaluation List (S. Cohen, R. Mermelstein, T. Kamarzk, & H. Hoberman, 1985); and measures of collegiality, time pressure, and job dissatisfaction were completed by 204 attorneys (159 men and 45 women). After controlling for age, gender, and other job characteristics, high Ho scores were related to lower perceived supportive collegiality at work. Low perceived availability of social support was related to greater job dissatisfaction. Neither hostility nor social support was associated with perceptions of time pressure at work. These findings suggest that hostility and availability of social support may be an important pathway linking certain job characteristics to cardiovascular disease and other illnesses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A quantitative analysis of the relationship between the Cook-Medley Hostility Scale and traditional coronary artery disease risk factors.

One possible explanation for the association between Cook-Medley Hostility Scale (Ho Scale; W. W. Cook & D. M. Medley, 1954) scores and premature coronary artery disease (CAD) morbidity and mortality is that hostile persons also have elevations on CAD risk factors. Meta-analyses with fixed and random-effects models were used to evaluate the relationship between Ho Scale scores and CAD risk factors in the empirical literature. Ho Scale scores were significantly related to body mass index, waist-to-hip ratio, insulin resistance, lipid ratio, triglycerides, glucose, socioeconomic status (SES), alcohol consumption, and smoking. Although there was also heterogeneity among study outcomes, the results of conservative random effects models provide confidence in the obtained relationships. On the basis of available evidence, researchers might give attention to obesity, insulin resistance, damaging health behaviors, and SES as potential contributing factors in understanding the association between Ho Scale scores and CAD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Potential hostility and dimensions of anger.

Examined the construct validity of Potential for Hostility ratings derived from the Structured Interview by correlating PH scores with 21 scales from 4 anger/hostility measures: the Buss-Durkee Guilt-Hostility Inventory, Multidimensional Anger Inventory (J. M. Seigel, 1985), Anger Self Report, and R. W. Novaco's (1975) anger inventory. Ss were 82 male college students (mean age 20 yrs) and 50 male faculty, staff and older students (mean age 40 yrs). Factor analyses yielded 3 components (Experience of Anger, Expression of Anger, Suspicion-Guilt). PH was correlated with the Expression of Anger factor in a 2-factor solution and was equally correlated with the Expression of Anger and Experience of Anger factors in a 3-factor solution. Implications for assessment of hostility are noted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Role of hostility in women's health during midlife: A longitudinal study.

Relationships between hostility at ages 21, 27, 43, and 52 years old and general health at age 52 were investigated in a longitudinal sample of educated midlife women. Hostility was assessed at ages 21 and 27 using the Cook-Medley Hostility Scale (HO), and at all four test sessions using a California Psychological Inventory (CPI) derived hostility scale consisting of 33 CPI items that were either duplicates or close equivalents of HO items. Hostility at each age was negatively correlated with general health at age 52. Further analyses revealed that hostility at each age remained a significant health predictor at age 52 when possible mediator variables at age 43 (cigarette smoking, excessive alcohol intake, body mass index, negative life events, and social role satisfactions) were controlled. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hostility, the metabolic syndrome, and incident coronary heart disease.

This investigation examined the impact of hostility and the metabolic syndrome on coronary heart disease (CHD) using prospective data from the Normative Aging Study. Seven hundred seventy-four older, unmedicated men free of cardiovascular disease were included in the study. The total Cook-Medley Hostility (Ho) Scale score, anthropometric data, serum lipids, fasting insulin concentrations, blood pressure, cigarette smoking, alcohol consumption, and total dietary calories were used to predict incident CHD during a 3-year follow-up interval. Multivariate analysis indicated that only Ho positively predicted and high-density lipoprotein cholesterol level negatively predicted incident CHD. Ho's effects on CHD may be mediated through mechanisms other than factors that constitute the metabolic syndrome. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Linkages between facial expressions of anger and transient myocardial ischemia in men with coronary artery disease.

The authors examined whether facial expressions of emotion would predict changes in heart function. One hundred fifteen male patients with coronary artery disease underwent the Type A Structured Interview, during which time measures of transient myocardial ischemia (wall motion abnormality and left ventricular ejection fraction) were obtained. Facial behavior exhibited during the ischemia measurement period was videotaped and later coded by using the Facial Action Coding System (P. Ekman & W. V. Friesen, 1978). Those participants who exhibited ischemia showed significantly more anger expressions and nonenjoyment smiles than nonischemics. Cook–Medley Hostility scores did not vary with ischemic status. The findings have implications for understanding how anger and hostility differentially influence coronary heart disease risk. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dimensions of hostility and aggression in abnormal offenders.

Analyzed the scores of 165 male inpatient psychiatric offenders on 17 hostility and personality scales (e.g., the MMPI). 4 factors were extracted, identified as aggression, hostility, introversion-extroversion, and age. Hostility and aggression were found to be notably oblique to each other and slightly negatively correlated with introversion-extroversion. However, the hostility factor was also identifiable as the neuroticism dimension. None of the factors could be identified as intropunitiveness-extropunitiveness, and the variance of the scales measuring these attributes was spread over the 1st 3 factors. It is concluded that 2 broad dimensions of aggressive response tendency and hostile evaluation may be sufficient to describe this area of behavior. (35 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Citalopram intervention for hostility: Results of a randomized clinical trial.

Hostility is associated with an increased risk for cardiovascular disease (CVD). Because central serotonin may modulate aggression, we might expect selective serotonin reuptake inhibitors (SSRIs) to be effective in reducing hostility. Such effects have never been examined in individuals scoring high on hostility who are otherwise free from major Axis I psychopathology according to criteria in the Diagnostic and Statistical Manual of Mental Disorders (4th ed., Text Revision; American Psychiatric Association, 2000). A total of 159 participants (ages 30?50 years, 50% female) scoring high on 2 measures of hostility and with no current major Axis I diagnosis were randomly assigned to 2 months of citalopram (40 mg, fixed-flexible dose) or placebo. Adherence was assessed by electronic measurement and by drug exposure assessment. Treated participants showed larger reductions in state anger (Condition × Time; p = .01), hostile affect (p = 02), and, among women only, physical and verbal aggression (p = .005) relative to placebo controls. Treatment was also associated with relative increases in perceived social support (p = .04). The findings have implications for understanding the central nervous system correlates of hostility, its associations with other psychosocial risk factors for CVD, and, potentially, the design of effective interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Anger, hostility, and depression in domestically violent versus generally assaultive men and nonviolent control subjects.

Anger, hostility, and depression were examined across four groups: a clinical sample of domestically violent men, two samples of more generally assaultive men, and a nonviolent control group. All subjects (N?=?129) were assessed using the Buss-Durkee Hostility Inventory, the Hostility and Direction of Hostility Questionnaire, and the Beck Depression Inventory. The domestically violent men and the generally assaultive men evidenced significantly higher levels of anger and hostility than the control subjects. The anger and hostility scores were very similar in the domestically violent and the generally assaultive men. However, the domestically violent men were more likely to be significantly depressed. The findings support the idea that anger dyscontrol is a key issue in the psychological profile of domestically violent men and indicate the need for clinical attention to depression as well as anger. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Meta-analytic review of research on hostility and physical health.

A new meta-analysis of research on hostility and physical health was conducted that includes 15 studies used in previous meta-analytic reviews and 30 new independent studies. Overall, the results suggest that hostility is an independent risk factor for coronary heart disease (CHD). For structured interview indicators of potential for hostility, the weighted mean r was .18. After controlling for other risk factors for CHD, the widely used Cook-Medley Hostility Scale and other cognitive-experiential measures were most predictive of all-cause mortality (weighted mean r ?=?.16) and, to a lesser extent, CHD (weighted mean r ?=?.08). Similar to other areas of research, the increased use of high-risk studies in recent years produced an increase in null findings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An exploration of the relation between hostility and disease

Hostility has been studied mainly in relation to coronary heart disease (CHD). However, given the pathways linking hostility to CHD, it might be expected that hostility also relates to non-CHD. Therefore, the relation between the expression and the experience of hostility and various health outcomes was examined in a cross-sectional design. The data were collected among male patients with a myocardial infarction in the age range of 30-70 years (N = 279) and a population sample of men in the same age group (N = 2663). Based on checklist of the most frequent disorders, the subjects from the latter group were divided into subsamples according to their disease status. Three components of hostility, i.e., resentment, suspicion, and aggression, were measured by the Buss Durkee Hostility Inventory (Buss & Durkee, 1957). The overall finding was that all components of hostility were related to non-CHD disease but not to CHD.     

Interpersonal Hostility Assessment Technique: description and validation against the criterion of coronary artery disease

High levels of hostility are associated with adverse health outcomes. The Interpersonal Hostility Assessment Technique (IHAT; Barefoot, 1992) measures hostility from verbal behavior during a standardized interview. Four types of behaviors are scored as hostility: evading the question, irritation, and indirect and direct challenges to the interviewer. The sum of the frequencies of these acts is a Hostile Behavior Index (HBI), which is divided into two components: verbal, scored with speech content in mind, and paraverbal, based on vocal stylistics. This study examined characteristics of IHAT assessments in 129 male coronary patients. Satisfactory interrater reliabilities were obtained. The HBI correlated highly (.58) with coronary artery disease severity after controlling for traditional risk factors. This relation was not affected by question topic or by differential weighting of the four hostile behaviors. Both HBI components were significantly correlated with disease. Results are discussed in terms of their implications for hostility assessment.     

Hostility, cigarette smoking and alcohol consumption in the general population

Hostility has been associated with coronary heart disease, and hostility may affect coronary risk through its influence on risk factors such as cigarette smoking and alcohol consumption. The objective of this study was to determine relationships between hostile personality, cigarette smoking and alcohol consumption in the general population. The Edinburgh Artery Study comprises a cross-sectional survey of 1592 men and women aged 55-74 years sampled from age-sex registers of 10 general practices throughout the city. The Bedford-Foulds Personality Deviance Questionnaire was used to elicit extrapunitiveness (including hostile thoughts), dominance (including hostile acts) and intropunitiveness. Social class, age and deprivation score were controlled for in multivariate analyses. The hostile thoughts scale emerged as a significant independent predictor of alcohol consumption in men and women (P < or = 0.01), and the models accounted for 4-9% of the variance in alcohol consumption. Hostile acts were independently predictive of smoking in men (P < or = 0.001), with the model accounting for 5% of the variance in smoking. Hostile thoughts were independently predictive of smoking in women (P < or = 0.001), and the model accounted for 4% of the variance in their smoking. We conclude that hostility may affect coronary risk through its influence on lifestyle-related coronary risk factors, although in future further elucidation of hostility type and standard measurement of hostility are necessary.     

The Aggression Questionnaire.

A new questionnaire on aggression was constructed. Replicated factor analyses yielded 4 scales: Physical Aggression, Verbal Aggression, Anger, and Hostility. Correlational analysis revealed that anger is the bridge between both physical and verbal aggression and hostility. The scales showed internal consistency and stability over time. Men scored slightly higher on Verbal Aggression and Hostility and much higher on Physical Aggression. There was no sex difference for Anger. The various scales correlated differently with various personality traits. Scale scores correlated with peer nominations of the various kinds of aggression. These findings suggest the need to assess not only overall aggression but also its individual components. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The expression and inhibition of hostility in imaginative and overt behavior.

"Half of a group of 40 white male college students, representing the extreme scores on the Segal Manifest Hostility Scale, were placed in a situation designed to arouse strong hostility, and half in a low arousal situation. Ss were then permitted to express hostility in fantasy (using TAT pictures selected for differences in cue properties relevant to hostility) and in overt behavior, in a situation in which Ss could actually hurt another person… . The results of this experiment were consistent with a goal gradient model in which high and low expressors were assumed to differ in strength of approach motivation (proximity to the goal)." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

What's so unhealthy about hostility? Construct validity and psychosocial correlates of the Cook and Medley Ho scale.

The Cook and Medley Hostility (Ho) scale, a measure of hostility derived from the Minnesota Multiphasic Personality Inventory (MMPI), was recently found in 1 cross-sectional study to be related to the severity of coronary artery disease and in 2 prospective studies to predict the development of coronary heart disease. The present 2 studies attempted to address concerns about the lack of information regarding the meaning of the scale and the psychosocial characteristics of individuals with high Ho scores. In Study 1, the Ho scale demonstrated convergent and discriminant validity. Data gathered on 85 undergraduates who completed a battery of inventories indicated that the scale primarily assesses suspiciousness, resentment, frequent anger, and cynical distrust of others rather than overtly aggressive behavior or general emotional distress. In Study 2, which tested 135 undergraduates on a similar battery of questionnaires, Ss with high scores displayed comparatively more anger, less hardiness, more frequent and severe hassles, and fewer and less satisfactory social supports. It is concluded that the Ho scale assesses cynical hostility and that high scores are associated with an unhealthy psychosocial risk profile. (3 p ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)